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Parenting and medical advice from Dr Bill Sears, Dr Jim Sears, Dr Bob Sears and Dr Peter SearsMon, 30 Mar 2015 14:28:17 +0000en-UShourly1http://wordpress.org/?v=4.1.1Breastfeeding Bondinghttp://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/building-closeness-breastfeeding
http://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/building-closeness-breastfeeding#commentsMon, 12 Aug 2013 15:57:52 +0000http://www.askdrsears.com/?p=1666Building Closeness through Breastfeeding Bonding When women look back on the time they spent breastfeeding their babies, what they most remember is the closeness, the intimate breastfeeding bonding. Whether you’re someone who is swept away by the romance of motherhood or a more practical person who feels the milk is there for a reason, the […]

When women look back on the time they spent breastfeeding their babies, what they most remember is the closeness, the intimate breastfeeding bonding. Whether you’re someone who is swept away by the romance of motherhood or a more practical person who feels the milk is there for a reason, the feeling of satisfying your baby’s hunger with your own milk will strike you as incredibly fulfilling.

Continue the “Oneness”

The breastfeeding bonding between mother and baby is important. When you feed your baby at the breast, you tap into a valuable resource for mothering and nurturing your baby that is tested and true; as old as time itself. When you choose to breastfeed, you continue the “oneness” that you and your baby experienced during pregnancy. Your body continues to provide nourishment, warmth, comfort and safety, just as it did when baby was inside you. Once you’ve mastered the basics, breastfeeding bonding will make mothering easier.

Breastfeeding is convenient. Food is available for baby within seconds wherever you go. No sterilizing bottles and nipples, and taking the time and effort to prepare formula.

Breastfeeding helps you know and understand your baby. It can affect the way you listen to your child, the way you communicate and the way you respond for many years to come.

Breastfeeding mothers take pride in providing food for their babies, and they feel confident about parenting children they know so well.

Learn to be Child-Centered

How does breastfeeding do all this? To breastfeed successfully, mothers must learn to pay attention to baby’s cues and trust them. Mothers learn to be child-centered, to think in terms of the baby’s needs and how to meet them. The many, many times and different ways in which a breastfeeding mother interacts with her baby make both members of the breastfeeding pair more sensitive to one another’s social signals.

Of course, it’s possible to breastfeed and ignore these lessons in lifelong parenting, but for most mothers and babies (and fathers, too) learning to breastfeed is an important step in building a trusting relationship that extends well beyond the baby years.

]]>http://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/building-closeness-breastfeeding/feed0Proper Positioning and Latch-on Skillshttp://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/proper-positioning-and-latch-skills
http://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/proper-positioning-and-latch-skills#commentsMon, 12 Aug 2013 15:56:44 +0000http://www.askdrsears.com/?p=1664There’s a right way–and a wrong way–for baby to latch onto the breast. When baby latches on correctly, mother’s nipples don’t get sore and baby is able to get plenty of milk. Everyone is happier. The easiest way to learn about good latch-on is in a one-on-one session with a knowledgeable lactation consultant, who can […]

]]>There’s a right way–and a wrong way–for baby to latch onto the breast. When baby latches on correctly, mother’s nipples don’t get sore and baby is able to get plenty of milk. Everyone is happier. The easiest way to learn about good latch-on is in a one-on-one session with a knowledgeable lactation consultant, who can show you, rather than tell you, how to get baby latched-on correctly. Many hospitals offer lactation services to postpartum mothers. You might also consider working with a lactation consultant or La Leche League Leader in your community.

With proper latch-on, puts most of mother’s areola into his mouth. (See illustration.) Mother’s nipple (1) goes to the back of baby’s mouth. The baby’s gums (2) compress the milk sinuses that lie about an inch behind the nipple. The tongue (3) is forward, underneath the breast, over the lower gum, and its motion helps baby draw out the milk.

GETTING POSITIONED

How you sit, how you hold your baby, and how you offer your breast all affect how baby latches on. Ultimately, these facts determine how comfortable you will be during breastfeeding.

Mom’s position (the cradle hold)

Sitting-upright in an armchair or rocking chair is the easiest position for breastfeeding. You can also sit up in bed, but make sure that your back, shoulders, and knees are well-supported. You’ll need several pillows.

Place one or more pillows behind your lower back, and/or shoulders so that you are comfortable and relaxed.

If you’re in bed, put pillows under your knees.

You’ll need at least one pillow in your lap to bring baby up to the level of your breast, and another under the arm that will support your baby as he breastfeeds.

If you are sitting in a chair, use a foot stool or something else to raise your lap so you don’t have to strain or lean over to get baby closer to your breast.

Why all the fuss about your comfort? Once baby is latched-on, you’re going to be stuck in this position for 20 to 30 minutes. You don’t want to be all knotted up when baby finally falls asleep in your arms.

Before you do anything else, be sure that your baby is awake and alert. A sleepy newborn can’t nurse effectively. Undress baby down to just her diaper, so that she has lots of stimulating skin contact while nursing. Hold her in front of you and gently raise her from a lying-down position to one where she is supported in front of your face. Call her name, talk to her gently, and repeat this until she is awake enough to nurse. If your baby is fussing or crying, calm her down before offering the breast.

Babies as well as mothers should be comfortable during breastfeeding. Baby’s breastfeeding reflexes work best when baby is well supported with her body comfortably aligned.

Use one or more pillows in your lap to bring baby up to the level of your breast. Don’t expect your arms alone to be able to hold her at breast height though an entire feeding. Use pillows and a foot support to bring baby up and in toward you. The baby comes to the breast, not the breast to the baby.

Nestle baby in your arm so that her neck rests in the bend of your elbow, her back along your forearm, her buttocks in your hand.

Turn baby on her side, so that she is facing you tummy to tummy. Pull her close to you, so that her body wraps around yours. Her head and neck should be straight and in line with her body, not arched backward or turned sideways. Baby should not have to turn her head or strain upward to reach your nipple. The breast should be right there in front of her little mouth.

What to do about those little arms flailing away? Tuck the lower arm under baby’s body, into the soft pocket of your midriff. You can hold the upper arm down with the thumb of the hand that is holding her. If it’s hard to control baby’s body, try swaddling her in a blanket.

Variations on this position

The position described above for mother and baby is called the cradle hold. It’s the most common way that mothers hold babies while nursing. But there are times when you might choose another position. When baby is having difficulty learning to latch on, try the Clutch Hold or the Reversed Cradle Hold for more support and a better view of baby’s mouth. The Side-Lying Position makes night-nursing and nap-nursing easier. Mothers with a tender tummy from a cesarean sometimes prefer the clutch hold or the side-lying position, to keep baby off their lap.

Offering the Breast

The hand that isn’t holding the baby supports your breast. Supporting the breast with your hand keeps the weight of it off baby’s lower jaw and chin. This will help him stay latched-on correctly. Try these tips for supporting your breast:

First, squeeze out a few drops of colostrum or milk to moisten your nipple.

Then cup your breast with your hand, palm and fingers underneath and thumb on top.

Keep your fingers clear of the areola, the darker area around the nipple, so that baby can take a big mouthful of breast.

If your breasts are very large, use a rolled-up hand towel under your breast to help support its weight.

Latch-on Basics: Breast and Baby Come Together

Open Wide. When the nipple touches baby’s lips, his mouth will open quickly, seeking the breast. You want to get your nipple into his mouth when it is as wide open as possible so that baby sucks on a good mouthful of breast tissue, not just on the nubbin of your nipple. Babies’ mouths close as quickly as they open, so you have only a split-second to get baby and breast together. Here’s what to do:

Use your nipple to tickle baby’s lower lip to encourage her to open her mouth wide–really wide.

As the mouth opens to its widest point, direct your nipple into the center and use your arm behind to pull baby in very close to you. Don’t lean forward, pushing your breast toward your baby; pull her close to your breast by moving your arm.

How to Get Baby to Open Her Mouth Wide

Baby’s wide-open mouth is the most important part of latch-on. If baby takes the breast as her mouth is closing, or if she slurps the nipple in through partially open lips, she won’t get enough breast tissue in her mouth. If baby sucks only on the nipple, mother will get very sore nipples and baby won’t get enough milk. You have to wait patiently for baby to open her mouth wide and then act quickly when she does. Even if you have to start over several times,(and you will in the beginning it’s worth working at until you get it right. Try these tips:

Talk to your baby and say “Open.” Show her what to do by opening your own mouth wide. Babies can imitate adult facial expressions.

Help your baby open her mouth wider by using the index finger of the hand supporting your breast to press firmly down on your baby’s chin as you pull her on. You will probably need someone else to do this for you at first.

If all has gone well, at this point baby will be successfully latched-on to the breast and will begin to suck and swallow. If you’re like most new mothers and babies, it may take several tries before you get going. If baby is not latched on well, press down on the breast or gently insert a finger in the corner of baby’s mouth to break the suction and try it again.

Be patient, relax, and use these checkpoints to evaluate whether baby has a good latch:

Mother should be relaxed, with baby well supported in her arms. If you end up sitting hunched over during feedings and have a tired, sore back when you’re done, you probably need another pillow in your lap to get baby up to breast height. Lean back into the pillows behind you and be sure you’re bringing baby to the breast, not the breast to baby. Use an additional pillow to support the elbow of the arm that is holding the baby. There are also breastfeeding pillows you can purchase that keep baby’s body aligned, yet raised to breast level. This is helpful for first-time moms who are overwhelmed with positioning baby’s body and getting baby to latch-on correctly.

Make sure baby sucks the areola, not just the nipple. Your baby’s gums should bypass the base of the nipple and take in at least a one-inch radius of the areola as he latches on. If baby is sucking on only the nipple, your nipples will be sore after just one or two feeding and miserable after many more. Another reason it is so important that baby compress the areola is that the milk sinuses (the reservoirs for milk) are located beneath the areola. If these sinuses are not compressed, your baby will not get enough milk. Babies should suck areolas, not nipples.

Baby’s top and bottom lip should be turned out (everted). When baby takes the breast with mouth open wide, he’ll have a “fish mouth” look as he nurses. If his bottom lip is pulled inward instead of outward, use the index finger of the hand that is supporting the breast to pull out that lower lip. (You may need a helper to take a peek under the breast and do this for you while baby is latched-on.) Martha Sears, who logged 18 years of breastfeeding 8 children dubs this technique the lower lip flip. This lower lip flip may be all that’s needed to keep baby from tight-mouthing your nipple.

Baby’s chin should be pressed into the breast with his nose resting on the breast, as well. You will notice that baby is able to breathe out the sides of his nose, even when pressed against your breast. Babies are designed that way. If your baby struggles, pull baby’s bottom closer to you, or use your thumb to press gently on the breast to make an airway.

Wrong latch-on. Baby’s lower lip should not be pursed inward, but should be turned outward.

]]>http://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/proper-positioning-and-latch-skills/feed0Is Baby Latching on and Sucking Efficiently? How to Tell?http://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/baby-latching-and-sucking-efficiently-how-tell
http://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/baby-latching-and-sucking-efficiently-how-tell#commentsMon, 12 Aug 2013 15:55:54 +0000http://www.askdrsears.com/?p=1662Latch-on and sucking checklist: You see the pink of baby’s lips. This tells you that baby’s lips are turned outward rather than tucked tightly inward. There is a tight seal between the baby’s mouth and the areola. Baby has a good mouthful of breast. Much of the areola (at least a one-inch radius) is inside […]

You see the pink of baby’s lips. This tells you that baby’s lips are turned outward rather than tucked tightly inward.

There is a tight seal between the baby’s mouth and the areola. Baby has a good mouthful of breast.

Much of the areola (at least a one-inch radius) is inside baby’s mouth. As the baby is sucking, you do not see the base of your nipple, but only the outer part of your areola.

Baby’s tongue is between the lower gum and your breast. If you pull down gently on baby’s lower lip, you should be able to see it. With a good latch-on, baby’s tongue extends over the lower gum, forming a trough around the nipple and cushioning pressure from the jaw.

Baby’s ears are wiggling. During active sucking and swallowing the muscles in front of baby’s ears move, indicating a strong and efficient suck that uses the entire lower jaw.

You hear baby swallowing. During the first few days after birth, baby may suck 5 to 10 times before you hear a swallow. That’s because colostrum comes in small amounts. You may have to listen carefully to notice swallows. After your milk has “come in,” swallowing will be obvious. After the baby’s initial sucking has triggered the milk ejection reflex, you should hear a swallow after every suck or two. This active sucking and swallowing should continue for five to ten minutes on each breast.

Milk does not leak much from the corners of baby’s mouth. Baby swallows the milk instead.

You don’t hear clicking sounds, which would indicate that baby does not have his tongue positioned correctly and is latched on incorrectly.

You do not see dimpling (the middle of baby’s cheeks caving in) during sucking. This would indicate that the baby has a poor seal on the breast and is breaking suction as he moves his gum and tongue. Pull baby off and try latching on again.

Eventually, you will know that your baby is latched-on and sucking efficiently by the way it feels. If you have a lactation consultant helping you, (which is a must for a first-time mom) pay close attention to how your nipple feels after the two of you have gotten the baby latched on correctly. There should be no pain. Also pay attention to how the sucking feels on the areola. You will actually feel a tingling sensation as baby draws the milk out of the milk sinuses. There will be no doubt that your baby has a solid and secure connection to your breast.

When baby is not latched on securely to the areola, the painful sensations in your nipples will register “Red alert! Lousy latch-on.” Do not persist with an incorrect latch-on. Take your baby off and start again. Be sure that you wait until baby’s mouth is wide open and the tongue is down and forward before pulling baby onto the breast. Rushing the latch-on results in baby gumming just the nipple. You’ll get sore and baby won’t get enough milk.

Be patient. Take a few deep breaths, calm baby down, and stay calm yourself. It takes a week or two for most mothers and babies to become skilled at breastfeeding.

What to do if you just can’t seem to get it right

With prompt attention, latch-on and sucking difficulties can usually be fixed within a few days. Here’s what to do:

Get help right away from a lactation consultant if you’re having trouble latching your baby onto the breast or feel that your baby is not sucking well. A lactation consultant will show you how to get baby to latch on better. She can also show you how to teach baby to suck correctly. Some newborns need to be taught how to suck more of the areola and with the back of the tongue instead of just sucking on the front of the areola with the front of the tongue. Incorrect sucking also causes sore nipples

Make certain that your baby is getting enough to eat. The first rule in solving breastfeeding problems is to feed the baby. Keep track of baby’s urine and stool output to determine if he is getting enough milk. After your milk has “come in,” baby should have 4 to 6 wet diapers a day (6 to 8 if you’re using cloth) and at least 2 to 3 substantial yellow, seedy stools. Some babies have a stool with every feeding. (The frequency of bowel movements decreases after the first month, as babies intestines mature.) If your baby is losing weight and is not having an adequate amount of wet diapers and bowel movements, talk to your doctor about supplementing your baby’s feedings until either your milk comes in or your baby learns to latch-on efficiently.

If supplementary feedings are necessary, avoid using bottles. Supplements can be given with a cup, spoon, eyedropper or feeding syringe, or a nursing supplementer. Using one of these will prevent the possibility of nipple confusion, caused by feeding baby with artificial nipples.

You may need to use a breastpump to keep up your milk supply until baby becomes a more efficient breastfeeder. The milk you pump can be given to your baby. To establish and maintain a milk supply for baby who can’t yet nurse very well, you need a high-quality electric pump. These can be purchased or rented.

Don’t be discouraged. Breastfeeding does not come naturally to most breastfeeding pairs. Moms need to learn how to help their babies latch-on correctly and babies need to be taught how to suck correctly. This takes time and lots of committment, like any worthwhile goal in life. Remember, it does get easier. Don’t give up!

]]>http://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/baby-latching-and-sucking-efficiently-how-tell/feed0Best Breastfeeding Positionshttp://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/best-breastfeeding-positions
http://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/best-breastfeeding-positions#commentsMon, 12 Aug 2013 15:53:56 +0000http://www.askdrsears.com/?p=1660Besides the cradle hold previously described try these time-tested positions: In the clutch hold, baby is positioned to the side of mother during breastfeeding, tucked under her arm. It is especially helpful for: Babies who have difficulty latching on Babies who arch their backs and squirm at the breast Babies who come off the nipple […]

]]>Besides the cradle hold previously described try these time-tested positions:

In the clutch hold, baby is positioned to the side of mother during breastfeeding, tucked under her arm. It is especially helpful for:

Babies who have difficulty latching on

Babies who arch their backs and squirm at the breast

Babies who come off the nipple frequently during breastfeeding

Babies who are small or premature

In this position you get a good view of baby latching onto the breast, while your hand at the nape of his neck gives you control of his head. Baby is bent at the waist, which helps tense babies relax better. If his body is relaxed, he’ll latch on better.

Here’s what to do:

Sit up in bed or in a comfortable armchair with your back and shoulders well supported. Position one or more pillows at your side to bring baby up to breast level. If you’re sitting in a chair, wedge the pillows between you and the arm of the chair.

Place baby on the pillow, tucked under your arm, with your hand on that side supporting his neck and shoulders. Bend him in the middle, so that his legs are pointed upward and his bottom rests against the pillow supporting your back, or against the back of the chair. Be sure that baby does not push his feet against the back of the chair, causing him to arch his back.

Cup the nape of his neck in your hand. Avoid holding the back of baby’s head, as this stimulates some babies to arch away from the breast. (If baby finds your touch too stimulating, put a cloth diaper or a receiving blanket between your hand and his skin.)

Pull baby in close to you using the RAM latch-on technique described in Latch-on Basics. Once baby is sucking well, wedge a pillow under the hand and wrist that are supporting baby at the breast to help hold him close.

Lean back into the pillows behind your shoulders, rather than hunching forward over your baby. Remember, bring the baby to the breast, not the breast to the baby.

Learning to nurse your baby lying down is invaluable. The side-lying position is relaxing and gets you more much-needed sleep. You can use it to nurse your baby at night or to nap-nurse during the day. This position is also beneficial for the mom who had a cesarean birth.

Here’s what to do:

The lying down position is basically the same as the cradle hold, but with baby and mother lying on their sides facing each other.

Place two pillows under your head, a pillow behind your back, a pillow under your top leg, and a fifth pillow tucked behind your baby. Five pillows sounds like a lot, but remember a golden rule of nursing: if mother is comfortable, baby is likely to be more comfortable, too.

Place your baby on her side facing you, and nestled in your arm. Slide baby up or down along the mattress to get her mouth lined up with your nipple.

Unless you need to lie down during feedings for physical reasons, the side-lying position is not the best to start with since you are less able to maneuver baby’s head to guide his latch-on. Best to use this position after good latch-on habits are established. If the side-lying position doesn’t work for you at first, keep coming back to it. As your baby becomes a better breastfeeder, it will get easier to latch him on well while you are lying down.

A reverse of the cradle hold, this across-the-body position allows better visibility of baby’s mouth during latch-on and better control of baby’s head. It’s a good alternative to the clutch hold if your baby needs extra support during latch-on, but you like the maternal feelings that come from having baby across your body. Use this position in the following situations:

Babies who have difficulty latching on.

Babies who come off the nipple frequently during breastfeeding.

Babies who are small or premature.

Here’s what to do:

Sit up in bed or in a chair with your back and shoulders well supported by pillows. Use one or more pillows in you lap to bring baby up to nipple level.

Hold baby in the cradle hold, but switch arms. The back of baby’s neck will rest in your hand rather than in the crook of your elbow. Use a small pillow or a rolled-up receiving blanket to support your wrist and hand.

Turn baby on his side facing you, with his nose lined up to your nipple.

Use your free hand to support the breast–fingers underneath, well back from the areola, and thumb on top.

Touch baby’s lower lip with your nipple and encourage him to open wide. As his mouth opens, pull him in quickly, “landing” the breast on his lower jaw and tongue first and then “rolling” him the rest of the way on. The breast will push his mouth open wider so that he gets a big mouthful.

As your baby gets better at sucking and staying on the breast, you can use the reverse cradle hold to get him started and then carefully ease baby into the regular cradle hold, being careful not to disturb his latch. You’ll end up with your elbow under baby’s head and the hand that was supporting baby now supporting the breast. Baby can nurse off to sleep in this position, and you can continue to hold him comfortable and gaze at his sweet face.

]]>http://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/best-breastfeeding-positions/feed0Breastfeeding Newborn Babyhttp://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/breastfeeding-newborn
http://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/breastfeeding-newborn#commentsMon, 12 Aug 2013 15:51:49 +0000http://www.askdrsears.com/?p=1658Bond With Your Breastfeeding Newborn Both mother and baby benefit from being in contact immediately after birth. Research in the hour or two after birth shows that this is a great time to begin the intimate relationship with your breastfeeding newborn. Studies show that a breastfeeding newborn who has early contact with their mothers learn […]

Both mother and baby benefit from being in contact immediately after birth. Research in the hour or two after birth shows that this is a great time to begin the intimate relationship with your breastfeeding newborn.

Studies show that a breastfeeding newborn who has early contact with their mothers learn to latch on more efficiently than babies who are separated from their mothers in the hour or two following birth.

This is a time when baby will be in a state of quiet alertness, the optimal behavior state for interaction with you. Her eyes are wide open, she is attentive and is looking for another set of eyes – and for the breast.

Remarkable films of newborns after birth have shown that babies draped over mother’s abdomen make crawling motions toward the breast and often find their target with minimal assistance.

Give your baby your full attention during this precious time. Gaze into her face, let her hear the voices of her parents that she already learned to recognize in the womb. Drape baby over your chest, tummy to tummy, cheek to breast, skin to skin. Your helpers can cover baby with a warm towel, and your body heat will keep her warm better than any elaborate hospital equipment.

Latching On and Sucking

As you hold your breastfeeding newborn skin-to-skin against your body, guide her movements and let her nuzzle at your nipple. Just relax and enjoy one another. Introduce your baby to the breast–don’t rush the breastfeeding. This first meeting is not a time to practice latch-on skills or worry about getting everything just right. This is a time for baby to discover where her food will come from, not a time to fill her tummy.

A breastfeeding newborn may lick the nipple at first. When they latch on, they take a few sucks, pause, and then may lick the nipple again or resume gentle sucking. Sucking in irregular bursts and pauses is the usual pattern for the first few hours, and sometimes even the first few days.

Sucking is good for the newly delivered baby. Crying is not. Sucking eases the tension that has built up during the stress of labor and birth. It is a familiar behavior, so it helps baby adjust to her new environment. Although it may seem that there is little or no milk in your breasts, your baby is getting colostrum: thick, yellowish “supermilk” that delivers concentrated germ-protecting factors and also has a laxative effect, helping baby clear the meconium from her system.

Infant sucking is also good for mothers immediately after birth. Stimulating the nipples triggers the release of oxytocin, which makes the uterus contract. This helps control postpartum bleeding and hastens the return of the uterus to its pre-pregnant size. Breastfeeding frequently in the first hours and days after birth will also help your milk “come in” sooner.

]]>http://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/breastfeeding-newborn/feed0Finding Professional Breastfeeding Helphttp://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/finding-professional-breastfeeding-help
http://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/finding-professional-breastfeeding-help#commentsTue, 30 Jul 2013 02:12:27 +0000http://www.askdrsears.com/?p=674Lactation consultants are health professionals with special training and experience in helping breastfeeding mothers and babies. Many are nurses or La Leche League Leaders and have personal, as well as professional, experience with breastfeeding. Lactation consultants may be on staff at a hospital or in a pediatrician’s office, or they may work in private practice. […]

]]>Lactation consultants are health professionals with special training and experience in helping breastfeeding mothers and babies. Many are nurses or La Leche League Leaders and have personal, as well as professional, experience with breastfeeding. Lactation consultants may be on staff at a hospital or in a pediatrician’s office, or they may work in private practice. How do I know if I need help from an LC?

We encourage first-time breastfeeding mothers to seek hands-on help from a professional lactation consultant within the first few days after birth. Reading about latch-on basics and trying to translate text and pictures into what to do with your baby at your breast can be difficult. It’s much easier to have someone show you early on, before latch-on problems turn into sore nipples or problems with baby not getting enough milk. Many hospitals provide lactation services as part of their standard maternity package. Take advantage of this service if it is available to you.

If your baby has difficulties with latch-on or sucking, or has other health problems that complicate breastfeeding, a lactation consultant can help you resolve these issues. If you find yourself in an especially difficult breastfeeding situation, ask around until you find an LC who has experience helping mothers with similar problems.

How do I find an LC?

A lactation consultant will usually have the credentials CLC (certified lactation consultant) or IBCLC (international board certified lactation consultant) after her name. To find a lactation consultant in your community, talk to your childbirth educator, health-care provider, or obstetrical hospital. Local La Leche League Leaders may also be able to refer you to a lactation consultant.

Many lactation consultants also rent or sell breast pumps and breastfeeding products. There are advantages to buying a pump from an LC rather than off the shelf at the department store. Besides selling you a pump or breast shells, a lactation consultant can tell you how to use the product and, most importantly, help you solve the problem that has created a need for a particular device. Lactation consultants are an invaluable resource for the new mother.

LA LECHE LEAGUE INTERNATIONAL

La Leche League is a wonderful source of information and support for breastfeeding mothers. The organization’s publications, expert resources, local volunteers and monthly meetings can give you the confidence you need to breastfeed and mother your baby successfully. From LLL you’ll get practical breastfeeding advice. It’s also a good source of support when family and friends ask questions like “Are you sure you have enough milk?” or “How long are you going to breastfeed that child?”

La Leche League volunteers are called “Leaders.” They are women with personal experience with breastfeeding, as well as special training in helping other mothers. League Leaders are available by phone when you have questions about breastfeeding your baby. They also lead monthly group meetings, where mothers share their experiences with breastfeeding.

LLL meetings are a great place to meet other women in your community who have young children. They’re also wonderful for pregnant women–just go and observe the mothers and babies. You can learn a lot about positioning a baby at the breast, nursing in public places, and about mothering in general just by observing.

La Leche League International’s website features articles and information on breastfeeding as well as an online catalog of books about parenting and breastfeeding, breast pumps, breastfeeding products and baby slings.

To find a Leader in your community, visit their website at lalecheleague.org or call 800-LALECHE. Many local La Leche League groups also have web pages that are linked to the LLLI home page.

]]>http://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/finding-professional-breastfeeding-help/feed0Breastfeeding After Cesarean Sectionhttp://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/breastfeeding-after-cesarean-section
http://www.askdrsears.com/topics/feeding-eating/breastfeeding/rightstart-techniques/breastfeeding-after-cesarean-section#commentsFri, 07 Jun 2013 18:40:58 +0000http://www.askdrsears.com/?p=158Studies show that women whose babies are born by cesarean surgery are just as successful at breastfeeding as mothers who deliver vaginally, as long as their commitment to breastfeeding remains high. It may, however, take a bit longer for mothers and babies to begin breastfeeding after cesarean surgery, and mothers’ milk tends to come in […]

]]>Studies show that women whose babies are born by cesarean surgery are just as successful at breastfeeding as mothers who deliver vaginally, as long as their commitment to breastfeeding remains high. It may, however, take a bit longer for mothers and babies to begin breastfeeding after cesarean surgery, and mothers’ milk tends to come in a bit later following a surgical birth. This may be a direct result of the surgery, or it may be because mothers who have cesareans have fewer opportunities for early and frequent breastfeeding.

If you know before you go into labor that you will be having a cesarean, talk to your doctor ahead of time about holding and nursing your baby immediately after the birth. Even if your cesarean was not the birth you anticipated, you can still make the most of the your baby’s first feedings. You will need extra help, since you’re doing double duty: healing yourself and feeding your baby. Try these time-tested helpers for successfully breastfeeding following a surgical birth:

Ask to see and hold your baby as soon as possible after birth. With help from nurses and your partner, you can enjoy skin-to-skin contact and give your baby an opportunity to nuzzle at your breast.

Plan to breastfeed your baby in the recovery room before the anesthesia wears off. With help from nurses, or your partner, you can put baby to the breast even if you must lie flat in bed.

Your doctor can prescribe pain medication for you that will not affect your baby. Pain suppresses milk production and makes it harder for you to enjoy your newborn. To decrease postoperative pain, talk to your anesthesiologist about using medications that will help you feel the most comfortable, yet alert, after the surgery. Long-acting analgesics (for example, Duramorph) injected into the spinal tubing immediately after birth can considerably ease postoperative pain.

Discuss with your doctor the use of “patient-controlled analgesia” (PCA) in which you administer your own pain-relieving medication as you need relief. Don’t hesitate to use pain medication–you and your baby will enjoy each other more if you are comfortable.

Plan to breastfeed early and often. When baby is hungry or fussing, have one of your attendants (either the nurse or your spouse), bring baby to you and help you position his body and mouth for efficient latch-on.

Ask your lactation consultant or attending nurse to show you how to breastfeed in the side-lying and clutch-hold positions. These positions keep baby’s weight off your incision. Lying down while nursing helps you rest and relax.

When nursing in the side-lying position, comfortably surround yourself with pillows. Place one or two pillows between your back and the side-rail, another pillow between your knees, a pillow under your head, and one under baby. To support your incision while lying on your side, wedge a tummy pillow (a small, foam cushion or even a folded bath towel) between the bed and your abdomen.

If you sit up in bed to nurse your baby, use lots of pillows to support your body. Put pillows under your knees to take the strain off your abdomen and back. Pillows on your lap under baby will protect your incision. You may find nursing sessions more comfortable if you get out of bed and sit in a chair.

Be sure your partner watches how the professionals help you breastfeed. Have them show him how to help you in the hospital and later on at home. It’s especially important for dads to learn how to help you with the lower-lip flip (see Latch-on Basics).

As much as possible, keep your baby with you in your room after a cesarean. Rooming- in is possible, even after a surgical birth. Get help from dad, grandma, or a friend – someone who can be with you most of the time in the hospital and lend a hand with the baby.

The decisions and details surrounding a cesarean birth may seem overwhelming at times. Don’t let this distract you from your precious time with your new baby. Do whatever you can to enjoy these first few days together.